CDCP FAQ
Proxima Dental is pleased to announce that we now accept patients eligible for coverage under the Canadian Dental Care Plan (CDCP), a government initiative designed to help Canadians without dental insurance.
It's important to note that Proxima Dental will continue to adhere to our regular fee guide, not the CDCP fee guide. As there may be variations between the CDCP fee guide and the Dental Association fee guide, patients may encounter differences in coverage percentages. The CDCP provides coverage based on adjusted family net income, which determines the level of assistance, but patients may still be responsible for a co-payment.
Proxima Dental will directly accept bulk payments from SunLife, the insurance provider for the CDCP. However, patients are expected to pay any remaining balance not covered by the CDCP at the time of service.
Please note that patients are responsible for understanding the terms of their CDCP coverage. Proxima Dental cannot provide specific details about the coverage or percentage of coverage; this information is managed by Service Canada and SunLife.
For comprehensive information on eligibility, coverage, and the application process, we recommend visiting the official Government of Canada website.
The Canadian Dental Care Plan (CDCP) is a federal initiative designed to provide dental care coverage to Canadian residents who lack dental benefits and have an adjusted family net income of less than $90,000 per year. While the CDCP is not a free dental program, it offers valuable government dental benefits, with potential co-payments based on income levels.
Key Points to Note:
- Eligibility: The CDCP is specifically for individuals who do not have existing dental coverage, including employer-provided benefits, pension benefits, or privately purchased plans.
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Phased Rollout: Different groups become eligible at different times:
- Seniors aged 65 and above: Applications opened in December 2023.
- Children under 18 and adults with a valid Disability Tax Credit certificate: Applications started on June 27, 2024.
- All remaining eligible Canadian residents: Applications begin in 2025.
Eligibility Requirements:
- Be a Canadian resident.
- Have filed a tax return in the previous year.
- Not have access to dental insurance.
Coverage Levels:
The exact percentages for different income brackets could not be confirmed in the search results. However, reported coverage levels under the CDCP vary based on adjusted family net income:
- Under $70,000: 100% coverage.
- $70,000 to $79,999: 60% coverage (40% co-payment).
- $80,000 to $89,999: 40% coverage (60% co-payment).
Services Covered:
The CDCP includes a range of dental services such as preventive, diagnostic, restorative, endodontic, prosthodontic, periodontal, and oral surgery services. Eligibility reassessment occurs annually.
For the most accurate and updated information, including eligibility criteria and application processes, visit the official Government of Canada website.
Eligibility for the Canadian Dental Care Plan (CDCP) is based on several factors, including age, disability status, and adjusted family net income. To qualify, your adjusted family net income must be less than $90,000 per year.
The application process is being rolled out in phases:
- Seniors aged 65 and above: Applications opened in December 2023.
- Children under 18 and adults with a valid Disability Tax Credit certificate: Applications started on June 27, 2024.
- All remaining eligible Canadian residents: Applications start in 2025.
Eligibility criteria include:
- Being a Canadian resident
- Having filed a tax return in the previous year
- Not having access to dental insurance
The government is sending invitation letters to eligible individuals when it's their turn to enroll.
To determine your eligibility, check the official Government of Canada website for the most up-to-date information.
Important Notes:
- If you have any form of dental insurance, including private or individual plans, you will be ineligible for the CDCP.
- Eligibility is reassessed annually.
For the latest updates and information about the CDCP and the application process, please refer to the official CDCP website.
No, the CDCP is designed for Canadian residents who do not have dental benefits and have an adjusted family net income of less than $90,000 per year.
Who is not eligible for the CDCP?
- Those with employer-provided benefits, including health and wellness accounts (for themselves or family members)
- Those with coverage through professional or student organizations
- Those with pension benefits (for previous employers or family members), unless retired before December 11, 2023, and unable to opt back in under pension rules
- Those with privately purchased coverage or through group plans from insurance or benefits companies
Employers are now required by the Canada Revenue Agency to report dental insurance coverage on T4/T4A forms, ensuring transparency for employees and their families.
Dr. Mohammad Al Kayalie emphasizes the importance of evaluating your existing coverage before considering CDCP enrollment. Cancelling current coverage could lead to unforeseen costs, as CDCP care may involve co-payments depending on your income level.
For comprehensive eligibility details, visit canada.ca/dental.
The Canadian Dental Care Plan (CDCP) covers a wide range of oral health care services, including:
Diagnostic and Preventive Services:
- Dental exams
- X-rays
- Cleaning (scaling)
- Fluoride applications
- Sealants
Basic Services:
- Restorative services: Permanent and temporary fillings, pain control for diseased teeth.
- Endodontic services: Root canal treatments, pulpectomies, procedures to reduce infection and relieve pain.
- Periodontal services: Cleaning under the gumline, treating abscesses.
Major Services:
- Advanced restorative services: Repairs to crowns, re-bonding of crowns and posts.
- Removable prosthodontic services: Complete dentures, denture repairs, relines, and rebases.
- Oral surgery: Removal of teeth and roots, surgical removal of tumors and cysts.
- Anesthesia or sedation services: Minimal sedation (conscious).
Preauthorization Required for Certain Services:
- Orthodontic services (to be added in 2025 for cases of medical need).
- Certain major services like crowns, partial dentures, and more complex anesthesia.
Important Notes:
- Coverage is based on the CDCP fee guide, which may differ from provincial fee guides.
- The level of coverage (100%, 60%, or 40%) depends on your adjusted family net income.
- Some services beyond established frequency limits may be covered with preauthorization.
- The CDCP is designed to address a range of individual oral health care needs and circumstances.
For a comprehensive list of all covered services, please visit the CDCP Dental Benefits Guide.
No. The CDCP is designed for Canadian residents who do not have dental benefits. To qualify for the CDCP, you must not have access to any type of dental insurance or coverage through:
- Employer-provided benefits, including health and wellness accounts for yourself or family members
- Professional or student organizations
- Pension benefits (for previous employers or family members), unless retired before December 11, 2023, and unable to opt back in under pension rules
- Privately purchased coverage or through group plans from insurance or benefits companies
Important to note: If you're eligible for dental coverage through employment benefits or an organization, you're ineligible for the CDCP, regardless of usage.
Employers are now required by the Canada Revenue Agency to report dental insurance coverage on T4/T4A forms, ensuring transparency for employees and their families.
Dr. Mohammad Al Kayalie emphasizes the importance of evaluating existing coverage before considering CDCP enrollment. Cancelling current coverage could lead to unforeseen costs, as CDCP care may prove more expensive than private insurance. Understand all details and costs to make the best decision for you and your family.
For comprehensive eligibility details, visit canada.ca/dental.
CDCP's Purpose
The CDCP is not intended to replace existing workplace or private dental benefits. The government has stated that the plan is designed to help Canadians without access to a dental plan.
Employer Reporting Requirements
Employers are now required to report on T4/T4A forms whether their employees and families have access to dental plan coverage, including spending and wellness accounts. This measure indicates the government is taking steps to ensure those with existing coverage do not unnecessarily enroll in the CDCP.
Eligibility for CDCP
Individuals with access to dental benefits through their employer, school, or other sources are
Encouragement to Maintain Existing Coverage
The British Columbia Dental Association (BCDA) and other dental associations strongly encourage employers and group plan providers to maintain dental benefits for their employees and members.
Future Implications for Employer-Provided Benefits
While the government’s intention is to improve access to care for those without coverage, there is still uncertainty about the long-term effects of the CDCP on employer-provided benefits. Dental associations continue to advocate for clarity to ensure the CDCP meets its goal without negatively impacting those who already have dental benefits.
